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A Prospective Study of Fel d1 and Der p1 Exposure in Infancy and Childhood Wheezing

Unitat Recerca Respiratòria i Ambietal, Institut Municipal Investigació Mèdica; Universitat Pompeu Fabra; Pediatrics Service, Hospital del Mar, Barcelona; Area de Salud de Menorca, IB-SALUT, Menorca, Spain; and Department of Occupational and Environmental Medicine, Imperial College, London, United Kingdom

Correspondence and requests for reprints should be addressed to Jordi Sunyer, M.D., Institut Municipal Investigació Mèdica—Environmental Respiratory Research Unit, Institut Municipal d'Investigació Mèdica, C. Doctor Aiguader 80, 08003 Barcelona, Spain. E-mail: jsunyer{at}imim.es

The impact of domestic exposure to cat allergen (Fel d1) and house dust mite (Der p1) on wheezing from birth to the age of 4 years was investigated in a multicenter prospective birth cohort; 1,611 mothers were recruited before delivery in Ashford, England, and Barcelona and Menorca, Spain. Exposures were gathered via dust sample collection at children's home in their first year of life. Families provided complete outcome data (wheezing status in all 4 years) for 1,289 children. Domestic allergen levels varied substantially between centers. Six hundred three (47%) children never wheezed during their first 4 years of life. Der p1 did not correlate with any type of wheezing outcome. Fel d1 significantly increased the risk of wheezing in 3- and 4-year-olds in comparison to 1-year-olds. Distinct risk profiles were found for wheezing at different ages. Multivariate analysis revealed an interaction between Fel d1 and maternal asthma among children who wheeze in Year 4 (relative risk = 2.77; 95% confidence interval = 1.19–6.46). Our data support the idea that several patterns of wheezing with different risk profiles exist among young children. The effect of Fel d1 exposure varied according to age and maternal asthma.

Key Words: allergens cohort • infants • wheezing

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